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Move to ban upfront payment for healthcare services is passed

Legislation banning upfront payment for healthcare services was passed in the House of Assembly last night, despite opposition from the One Bermuda Alliance.

Health Minister Zane DeSilva said the legislation would help the Island's least fortunate receive medical care, but OBA Seniors spokeswoman Louise Jackson said it would have negative side effects that could increase healthcare costs.

The legislation is backed by the Bermuda Health Council, but has been opposed by the Bermuda Dental Association, the Bermuda Medical Association and the Bermuda Medical Society.

The regulations, which come into effect August 1, forbid healthcare providers from charging patients for the insured portion of any treatment up front.

It also requires that insurers make all patient information electronically available, and that insurers pay their share of claims within 30 days.

Introducing the legislation at the House of Assembly, Mr DeSilva acknowledged that the Health Insurance (Health Service Providers and Insurers) (Claims) Regulations 2012 had encountered opposition, but said it would make a positive impact for the public in a difficult economic time.

“The reason for this change is to protect patients' access to healthcare,” Mr DeSilva said. “In the end the patients have to come first, and this legislation will ensure just that.”

Mr DeSilva declared last night “a great night for our people”. He said for the past two years he has worked to find a solution that works for everyone, but has encountered repeated resistance. As a result, he said the Ministry has been forced to legislating the issue.

“This was not the first chance, but it became the only option,” he said.

Mrs Jackson said that she supported the stated intention of the bill, but declared that in its current state the legislation would have a raft of unintended consequences.

A large portion of the problem, she said, is late payments by the Government insurance schemes, which she alleged caused healthcare providers to ask for up front payment initially.

While Mr DeSilva insisted that payments are now made within three to 30 days if claims are made electronically, Mrs Jackson said providers are still encountering problems receiving payments.

“How can you run a business as a practising doctor or dentist if the claims which are really what you are making money off of, are owed to you for ten years?” she said.

Those issues are further complicated, she said, by a lack of understanding as to what government healthcare schemes cover and what they don't.

She argued that the legislation would lead healthcare providers to quietly turn away patients based on their insurance, and that lost income could lead to medical professionals leaving the Island.

Even though the legislation does require insurers to pay claims within 30 days, Mrs Jackson questioned if government insurance schemes would be treated differently, causing lingering issues.

“The big, big problem is in this legislation, Government is policing itself,” she said. “How far do you think they are going to go punishing their own government insurance schemes? That is one of the big problems.”

She added that the cost for some healthcare providers to update to electronic systems by August 1 would be passed on to patients in the form of higher fees.

She dismissed the legislation as a poorly considered political move, but MP Kim Swan, elected under the UBP banner, defended the legislation.

He said some people are currently forgoing medical treatment because of the cost, a decision which can lead to even larger medical problems in the future, and even death.

“I would rather err on the side of patients than err on the side of someone making money,” Mr Swan said.

Both the Health Insurance (Health Service Providers and Insurers) (Claims) Regulations 2012 and the Health Insurance Amendment Act 2012 were passed.

lFor further coverage of the debate, read Wednesday's edition of

The Royal Gazette.

A move to ban upfront payments for healthcare services has been passed in the House of Assembly.

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Published March 20, 2012 at 9:00 am (Updated March 20, 2012 at 9:54 am)

Move to ban upfront payment for healthcare services is passed

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